Case Report
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World J Orthop. Oct 18, 2013; 4(4): 323-326
Published online Oct 18, 2013. doi: 10.5312/wjo.v4.i4.323
Treatment of C2 body fracture with unusual distractive and rotational components resulting in gross instability
Darryl Lau, Samuel S Shin, Rakesh Patel, Paul Park
Darryl Lau, Paul Park, Department of Neurosurgery, University of Michigan, Ann Arbor, MI 48109, United States
Samuel S Shin, Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, United States
Rakesh Patel, Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI 48109, United States
Author contributions: Lau D, Shin SS, Patel R and Park P all contributed to this work; Lau D and Park P designed the report; Patel R and Park P were the attending surgeons for the patient; Lau D and Park P analyzed the study; Lau D, Shin SS and Park P organized the case; Lau D and Shin SS performed the literature search; and Lau D, Shin SS, Patel R, and Park P wrote and critically edited the paper.
Correspondence to: Paul Park, MD, Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-533, United States. 8
Telephone: +1- 734-6152627 Fax: +1-734-9369294
Received: June 4, 2013
Revised: August 2, 2013
Accepted: September 13, 2013
Published online: October 18, 2013

Cervical fractures can result in severe neurological compromise and even death. One of the most commonly injured segments is the C2 vertebrae, which most frequently involves the odontoid process. In this report, we present the unusual case of a 28-year-old female who sustained a C2 vertebral body fracture (comminuted transverse fracture through the body and both transverse processes) that had both a significant distractive and rotational component, causing the fracture to be highly unstable. Application of halo bracing was unsuccessful. The patient subsequently required a C1-C4 posterior spinal fusion. Follow-up computer tomography imaging confirmed fusion and the patient did well clinically thereafter.

Keywords: C2, Distractive, Odontoid fracture, Rotational, Spine, Type III, Unstable

Core tip: Patients with a transverse fracture through the C2 body can have significant distractive and rotational components leading to significant instability. In such cases, external bracing may not be the best method of treatment. Rather, surgical stabilization is needed in order to promote optimal outcome.